HomeMy WebLinkAbout07050199 Application
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C't ifC l/CZ 'T' h' Permit #: () 10, <) tJ Iii
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COMMERCIAL/INSTITUTIONAL/MUL TI-F AMIL Y IMPROVEMENT LOCATION PERMIT
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APPLICATION (For New Structures, Additions, Remodels, Tenant Finishes, & Accessory Buildings)!
BUILDER NAME: PHONE: FAX:
OF Gordon Allen, Inc. 317-502-3621 317-873-5966
RECORD: STREET ADDRESS: CITY: STATE: ZIP:
7089 East County Road 200 N Avon Indiana 46123
BUILDER'S EMAIl ADDRESS: BEST METHOD OF CONTACT:
wallen@prudential alIen. com Cell 1/ 317-502-3621
PROPERTY NAME: PHONE: FAX:
OWNER: Gordon/Wanda Allen 317-873-5766 317-873-5966
STREET ADDRESS: CITY: STATE: ZIP:
7089 East Ct. Rd. 200N Avon Indiana 46123
LOCATION ADDRESS OF CONSTRUCTION: SUITE #: (If Applicable)
&. PROJECT 4370 Weston Pointe Drive Suite 140
INFO: Address of Shell Building: (If different than Address of Construction) I Lot # and Subdivision: (If Applicable)
BUlLDING, PROJECT, OR TENANT NAME: I ZONING: /15" - ~ TAX MAP PARCEL #:
Garrett Wietholter-State Farm Insurance
STATE COMMERCIAL '3 ~ (., 0.).(, SCOPE(S) OF 0 FDN 0 STR ~H ~ 0 PLUM SQUARE
DESIGN RELEASE #: RELEASE: ~ 0 SPKLR OTHER(S): FOOTAGE: 1290
WATER UTlUTY E,dstir.g SEWER UTIUTY Existing ESTIMATED cosr OF CONSTRUcnON:
PROVIDER: City or Carmel PROVIDER: C'" Township Reg.W s(EXCLUDING LAND VALUE) $65,000
..lay
PLAN COMMISSION / BZA / BPW DOCKET NUMBERS; AND/OR I/-B
COUNTY WEll AND/OR SEPTIC PERMIT #'S (If Applicable): ~
# of Floors: / Elevator or Lift: Q YES w:rOO 1 BLDG. CONSTRUcnON TYPE: S~L.4j' (/1 OCCUPANCY ClASSIFICATION: 13
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PROJECT INFORMATION:
......... rOMMEROAL 0 NEW STRUCTURE Early Release ~ Manufactured
~ (Privately owned hospitals and medical 0 AOOmON Permit: _ Y _N.____ Trusses:
offices/centers are commerclal) 0 Room(s) ~.
o INSTITUllONAL 0 Porch Lot Split: _Y _N Sump Pump:
o Municipal/Public IiileLEASED FOr:Q';[l'\eg"'''''''' Q",,,,-
o School Subject t q '~EMOb'El") I ;,01.., IIO!\FLOOD ZONE AREA DESIGNATIONrSl FOR THIS PROPERTY:
o Church 0 ~~IINEW'Ti:'IiiANT'FiN~lati0ns ~ L -1_ -'
o MULTI-fAMILY of :;t~aAC:CES50RYJlW14mNG -}-t rrsr ~
Number of units: DEPT OF OOr 'DEmA"'~",",GAM~ f .
----,-- ~ viiiru'tVE6 t;ARJ(G'E'VICES PLUMBING CONTRACTOR:
FOUNDATION TYPE: (checll'llliQ'hQf' L.A@EcEl~dwfik:' iii,f,dWNS _. II _ (/ _ A)
apply for the new construction area) d NI!;l:(ANl)l{ER ~O-Loc:..:TE HIP S toke s P l.Umb 1-ng t J...1r rl-j~tJl~
~LAB 0 CRAWL SPACE 0 DEMOLITlON Plumber's Indiana State Licensh
o POST & BEAM _PIER 0 BASEMENT (WALKOLrr:_Y_N) pC <j{ 8' "({ 0 /3'? S-
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Class I structure pennits are subject to the General Administrative Rules of the State of Indiana (See 675 lAC 12) regarding expiration time frames for beginning and
completing constructioD.
I, the undersigned, agree that any construction, reconstruction, enlargement, relocation, or alteration of a structure, or any change in the use of land or structures requested by
this application will amply with, and confonn to, all applicable laws of the S~ate of Indiana, and the "Zoning Ordinance of Carmel Indiana - 1993~ (Z-289) and amendments,
adopted under "ty of l.c. 36-7 et seq, General Assembly of the State of Indiana, and all Acts amendatory thereto. I further certify that only kitchen, bath, and floor drains are
connected to samtary sewer I funber cernfy that the construction Will not be used or occupied untIl a certJn;; of Occupancy or Subsuntja./ CompJetJon has been
"su<db, D,p., n,o!Commu t1'I:::--~~p r///FP #?
. Pnnt ~te
OFFICE USE ONLY: * ** * * ** * * ** * * * ** * ** ** * ** ** ** ** ** * * ** * ** * * * ** * * ~_~:~~* ** * * ** * * * ** *** ** ~ ** *
INSPECTIONS REQUIRED: Filing Fees: !:J;Z , 0 0 '
JO<?O()
I / .. 00
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Base Inspections:
Cert. of Occupancy:
~"I~Wed/A
'lts/Form
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Fee Received by:
Date